Age is not a Condom: HIV Prevention and the over 50s

It might come as a bit of a surprise, but contrary to popular stereotypes older people do have sex! Although sexual activity does often decrease with age, a recent American survey showed 73% of 57-64 year olds had had sex in the last year (see here ). Most older people, then, do desire sex and are at risk of STIs, including HIV. Indeed, the age group with the fastest rising number of new HIV infections in the UK, and around the world, is the over 50s group (see here , also see THT video looking at this trend. Before explaining why this might be the case let’s look at the numbers.

The Stats

The number of newly diagnosed HIV cases in the UK peaked at the start around the middle of last decade and have since tailed off. Newly diagnosed cases were round about 8,000 in 2005 and are about 6,500 currently.

There are two main groups that buck the trend – MSM (men that have sex with men) and over 50s (of any sexual orientation); both of these have seen increasing HIV rates over the last 10 years of so. Perhaps most strikingly is the latter. New diagnoses among older adults have more than doubled between 2002 and 2011 rising from 442 in 2002 to 872 in 2011. As a result of this and of more effective treatment and better survival rates the number of those living with HIV who are over 50 has increased five-fold in the same period from just under 4,000 to just under 17,000 in the same period. The stats also show that those aged over 50 are more likely to diagnosis late for HIV, which can increase treatment complications and reduce life expectancy. (See more info here . For detailed informaiton on ageing and HIV, visit the Terrence Higgins Trust (THT) website ).

That question isn’t a straightforward one to answer, but there are various ideas why this might be the case. One possibility is that the over 50s grew up in pre-HIV generation where condom use was not as common and are less inclined to use condoms today. Another reason might be a lack of knowledge about HIV transmission by those that are over 50s compared with those that are younger and are likely to have studied this in school and elswhere. There is also the idea amongst some of those that are over 50s that because of their age ‘it doesn’t matter’ if they become HIV positive and any reduction in life expectancy is going to be minimal which might reduce condom use. Another reason is that there is evidence that stigma of HIV/AIDS is greater amongst older people which can lead to less discussion of safer sex. Finally, there is evidence that those who have started having sex with a new partner in their 50s following a divorce or death of a partner are more likely to have unprotected sex, particularly if this is something that they used to do with their previous partner(s) (see here) . Whatever the reasons, it is clear that HIV prevention targeted at the over 50s is increasingly important in the UK and beyond. General messages so far have focused on the idea that age is not a condom and just by being older you are not protected from becoming HIV positive, such as the poster below.

What approaches should future HIV prevention with the over 50s take? What works and what doesn’t work with this age group? What message needs to be put across to those who are older and sexually active?

The GMI Partnership works with MSM of all different ages who live, work or socialise in London offering free counselling, mentoring and one-to-one sexual health sessions. For more information on our programmes our homepage.

The views in the article are those of the author and do not necessarily represent those of the GMI Partnership.